Healthcare Provider Details

I. General information

NPI: 1841056322
Provider Name (Legal Business Name): CHARMONY FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26442 BECKMAN CT
MURRIETA CA
92562-7022
US

IV. Provider business mailing address

23811 WASHINGTON AVE STE C110-259
MURRIETA CA
92562-2275
US

V. Phone/Fax

Practice location:
  • Phone: 951-226-1846
  • Fax: 951-226-1728
Mailing address:
  • Phone: 951-440-4083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. AGAEZI SONYA
Title or Position: CEO/DIRECTOR
Credential:
Phone: 951-440-4083